Our St. Luke’s Hospice Community Services (SLHCS) team offers a range of support to enable patients and their families to be cared for at their place of residence to avoid unwanted admission, if it is their choice.

We are proud to work in partnership with organisations such as SPDNS Homecare and Marie Curie, and aim to work collaboratively with the patients, their family and any service involved in their care.

As highly skilled professionals the team work often unassumingly to provide care 24/7 in the communities we support.

To showcase how they make positive impacts on patients and their carers, we are highlighting a snippet of their typical work shift. We are taking a look today at a patient visit with Tracy Cunningham, our Assistant Director of St. Luke’s Hospice Community Services.


SITUATION Tracy is a manager working today clinically as palliative care Clinical Nurse Specialist (CNS) from the hospice and visiting Enzo in his home. He has a life limiting illness. This is an urgent visit as his family are concerned about Enzo.

BACKGROUND Enzo has been mobile and attending appointments previously, although they have noticed a change is his condition recently. However today he has not been able to mobilise, is unable to take any of his medication and is sleeping a lot.

ASSESSMENT On arrival, Enzo appears to be deteriorating rapidly. He is on the settee, he has not drank very much at all and is intermittently sleepy. He had not taken any of his daily oral medication including his long acting analgesia. His family are very concerned, and one member is hopeful he will improve.

I initially check what injectable medication is in the house in case he requires any, there is anticipatory medication just in case. Initially Enzo manages with encouragement to take a small amount of fluid and his long acting medication.

I assist with personal care, spend time speaking with his family to ascertain how they think Enzo is. One member recognises his deterioration, but the other member feels he will improve.

I gently explain that I think Enzo is deteriorating and that improvement is unlikely, however we will assist and provide support as much as we can. I have arranged for another visit later that day.

RECOMMENDATION I handover and arrange for my colleagues to visit later tonight to support his family and assist Enzo with personal care and medication if he needs it. I recheck that the relevant documents have been completed e.g. DNACPR form.

I write down information for the relatives to contact the service (available 24/7) if they have any concerns. The overall impact of this visit was that I was able to be responsive in a timely manner resulting in Enzo being able to stay at home and avoid hospital admission.

His relatives felt supported and reassured. Enzo remained safe at home and his symptoms were controlled. He was supported during the dying phase of his illness and his relatives were also supported to allow Enzo to spend his last days of life where he wanted to be and to die peacefully at home surrounded by those that loved him.

His relatives had access to the necessary support both pre and post bereavement. Enzo was known to several teams, so we are able to be the coordinators across the wider team and provide support.

St. Luke’s Hospice Community Services (SLHCS) offers a range of support to enable patients and their families to be cared for at their place of residence to avoid unwanted admission if it is their choice, aiming to work collaboratively with the patient, their family and any service involved in their care.

Are you a nursing professional who would like to join our team? Our latest vacancies are available on our website or contact us on 01268 524973 to enquire about joining our team.